Treatment of Lagophthalmos

Medical

Goal: Maintaining a normal corneal epithelium

Temporary: Lubrication, moisture chamber Used at varying intervals Ointments are more effective in corneal protection; however, they often substantially blur vision. If this is not effective or if the paralysis is expected to persist, more permanent therapy would include procedures which narrow the palpebral fissure such as tarrsorhaphy (see below)

Goal: Closure of the eyelids to narrow the palpebral fissure and decrease evaporation.

Horizontal Closure

Permanent: lateral tarsorraphyTarsorrhaphy has been the standard method of managing exposure keratitis and is often effective if large enough.large tarsorrhaphies might possibly be disfiguring and limit peripheral vision.a lateral tarsorrhaphy of

Medial tarsorrhaphies

more disfiguring

generally used as a last resort in managing surface exposure.

Vertical Closure

Lower-lid elevation with spacers

fascia lata or silicone sling to lower eyelid

Hard palate or Alloderm implant

Midface lift

Upper eyelid lowering

gold weight (e.g. Lid Load) insertion a light (1 mg weight ) manufactured by various companies in weights from 0.6 to 1.6 grams might possibly be fixed to pretarsal space of the upper eyelid.The weight allows the eyelid to close more easily.The weights might possibly be taped to the pretarsal portion of the upper lid to determine which size will be needed to reduce the Lagophthalmos.Excess weight might possibly cause Ptosis.

Implantation involves an incision at the upper lid crease which exposes the anterior surface of the tarsal plate. The weight is then secured in position

Lagophthalmos: Patients with lagophthalmos have an inability to close eyelids. This might possibly occur, for instance, in patients with Thyroid eye disease. Visit the lagophthalmos page for more details.

Ptosis:Ptosis is may also be called Blepharoptosis. It refers to an eyelid which is droopy. This might possibly cause a loss of vision, especially while reading, headaches, and eyebrow strain. Please click on the Ptosis page for more details.